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Usefulness of Dual X-ray Absorptiometry-Derived Bone Geometry and Structural Indexes in Mastocytosis.
Calcified Tissue International ( IF 4.2 ) Pub Date : 2020-08-24 , DOI: 10.1007/s00223-020-00749-5
Fabio Massimo Ulivieri 1, 2 , Luca Rinaudo 3 , Luca Petruccio Piodi 4 , Valentina Barbieri 5 , Giorgio Marotta 1 , Mariarita Sciumè 6 , Federica Irene Grifoni 6 , Bruno Mario Cesana 7
Affiliation  

Reduced bone mass with or without fragility fractures is a common feature of mastocytosis, particularly in adult males. However, bone mineral density does not account for all the fragility fractures, being a part of them attributable to impairment in bone quality. Aim of this study is to assess the usefulness of DXA-derived geometry and structural indexes in the assessment of bone status in mastocytosis. Ninety-six consecutive patients (46 women and 50 men) affected by cutaneous (CM) or systemic (SM) mastocytosis were studied. Mean age (± SD) was 53.3 ± 14.23. Spine lateral X-rays for Genant's scale, DXA for lumbar (L) and femoral (F) bone mineral density (BMD), bone strain index (BSI), lumbar trabecular bone score (TBS), and hip structural analysis (HSA) were performed. Among the laboratory variables, data of serum tryptase were reported. Tryptase was higher in SM (p = 0.035), inversely correlated with LBMD (r = − 0.232; p = 0.022) and TBS (r = − 0.280; p = 0.005), and directly with L-BSI (r = 0.276; p = 0.006). L-BSI remained statistically significant (p = 0.006; adjusted R2 = 0.101) together with mastocytosis (SM or CM: p = 0.034) in the multivariate regression model with tryptase as dependent variable, being LBMD and TBS not statistically significant (p = 0.887, and p = 0.245, respectively). Tryptase increased about 22 units for each unit increase of L-BSI and about 18 units for SM against CM. L-BSI was lower (p = 0.012), while FN-BSI and FT-BSI were higher in women (p < 0.001) than in men. HSA indexes were significantly higher in men, particularly with SM. SM is a risk factor for reduced bone mass, texture and strength. Since mean L-BSI and Z-modulus of all the femoral sites are statistically higher in men than in female, it could be argued that men have a better femoral bone resistance to bending forces than women, but a worse lumbar bone resistance to compressive loads. DXA indexes of bone quality are useful in mastocytosis’ bone assessment and its clinical management.



中文翻译:

双重X射线骨密度仪得出的骨几何结构和结构指标在肥大细胞增多症中的作用。

伴有或不伴有脆性骨折的骨量减少是肥大细胞增多症的普遍特征,特别是在成年男性中。但是,骨矿物质密度并不能解决所有的脆性骨折,而其中一部分归因于骨质的损害。这项研究的目的是评估DXA衍生的几何结构指标在评估肥大细胞增多症的骨状态方面的有用性。研究了连续96例受皮肤(CM)或全身(SM)肥大细胞增多症影响的患者(46名女性和50名男性)。平均年龄(±SD)为53.3±14.23。Genant量表的脊柱外侧X线,腰椎(L)和股骨(F)的DXA骨矿物质密度(BMD),骨应变指数(BSI),腰椎小梁骨评分(TBS)和臀部结构分析(HSA)执行。在实验室变量中,报告了血清类胰蛋白酶的数据。p  = 0.035)与LBMD(r  = -0.232 ; p  = 0.022)和TBS(r  =-0.280; p  = 0.005)成反比,并与L-BSI(r  = 0.276; p  = 0.006)成反比。 在以胰蛋白酶为因变量的多变量回归模型中,L-BSI 与肥大细胞增多(SM或CM:p = 0.034 )一起在统计学上仍显着(p  = 0.006;调整后的R 2 = 0.101),LBMD和TBS在统计学上不显着(p  = 0.887和p 分别为0.245)。每增加L-BSI,胰蛋白酶增加约22个单位,对于CM,SM增加约18个单位。 女性的L-BSI较低(p = 0.012),而 男性的FN-BSI和FT-BSI较高(p <0.001)。男性的HSA指数显着较高,尤其是SM患者。SM是降低骨量,质地和强度的危险因素。由于男性所有股骨部位的平均L-BSI和Z模量在统计学上均高于女性,因此可以认为男性比女性具有更好的股骨抗弯曲力能力,但腰椎对压缩负荷的抵抗力更差。DXA骨质量指数可用于肥大细胞增多症的骨评估及其临床管理。

更新日期:2020-08-25
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